Format of The FCPS Dissertation Research Protocol
Format of The FCPS Dissertation Research Protocol
(Please use this format for typing your protocol on A4 size offset papers, but you may increase the space within
any cell or attach extra sheets if required). Please put ‘NA’ against any section that is not applicable
5. Title of the
dissertation/Thesis
6. Summary
(in around 300 words)
with key words
7. Place of study
8. Study Period
9. Study design
10. Introduction/context
(including a short review
of the relevant literature
and preliminary
observations)
11. Rationale of the
research
(its
scientific/medical/social
impact)
12. Research Question /
hypothesis
(as applicable)
13. Objectives a. General
b. Specific
14 Materials and Methods a) Main outcome variables to
. (in sufficient details to be studied
enable relevant authority b) Confounding variable
to assess:
how they would c) Study population (mentioning
achieve the stated species and strains, ethnic group,
objectives age, sex and other relevant
whether they are characteristics)
feasible) d) Sample size and the statistical
basis of it
Give relevant references, e) Screening methods, if
where applicable, in the applicable
‘References’ section. f) Sampling method (s)
g) Inclusion and exclusion
criteria
h) Operational definitions
i) Flow chart showing the
sequence of tasks
j) Procedures of preparing and
organizing materials (e.g., into
groups)
k) Nature of controls, if
applicable
l) Randomization and blinding
methods, if and as applicable
m) Equipment’s to be used
n) Procedures of collecting data
(including methods of
intervention, measurement,
estimation etc)
o) Professional assistance from
experts, if applicable
p) Procedure of data analysis of
interpretation (including
methods of statistical analysis –
specific methods and software
used for individual analysis)
q) Quality assurance strategy
r) Time table
15 Ethical implication
Think carefully about possible ethical implications and put
your views in short here.Follow the guidelines from the
appropriate Ethical Review Committee (s) of the concerned
institution (s) and/or BCPS and attach necessary documents
accordingly.
16 Total Budget
(dividing into main sectors of expenditure)
17 Source(s) of funding (if any)
18 Facilities available at the place of study
19 Other facilities needed
and the organization (s)/ institution(s) providing them
20 Dissemination and use of findings
21 References
(including the references for the “Materials & Methods”
section, if applicable
22 Any other relevant information
23 I solemnly pledge that this research protocol shall be implemented in accordance with the relevant
ordinance/ circulars of BCPS and funding agencies as when it is applicable. I hereby declare that no
part of the proposal research has been used in any thesis/ dissertation in partial fulfillment of any
degree/fellowship or any publication
I also understand that the BCPS reserves the right of accepting or rejecting this protocol.
Name: -----------------------------------------------
Name: ----------------------------------------
Designation : ---------------------------------------
Designation : --------------------------------
Seal: --------------------------------------------------
Seal: ------------------------------------------
ATTACHMENTS:
The following papers have been attached to each of the two copies of the protocol submitted:
1. Data collection instruments:-
e.g., subject recruiting materials, questionnaire, interview guide, group discussion guide,
physical/clinical data collection sheet etc. if and as applicable
2. Documents regarding ethical clearance as prescribed by the relevant body of BCPS.